小居, 理恵 Department of Anesthesiology, Tokushima University Hospital
片山, 俊子 Department of Anesthesiology, Tokushima University Hospital
EV1000 clinical platform
For anesthetic management during renal transplantation, it is necessary to maintain the blood flow and function of the transplanted kidney by performing massive fluid management and stabilizing blood pressure. We report anesthetic management for renal transplantation with a less-invasive circulatory monitoring system (Edwards Life Sciences Co., Ltd., Irvine, California, U.S.A.). In November 2010, renal transplantation was started in our hospital, and performed in 6 patients. In the first patient, fluid/circulatory management was conducted by connecting a standard arterial line and a standard central venous (CV) line. In the second patient, a FloTracTM system and a standard CV line were used. In the third patient, a standard arterial line and a PreSepTM CV Oximetry Catheter were used. In the fourth and fifth patients, a FloTracTM and a PreSepTM were used. In the latest patient, FloTracTM and PreSepTM were connected to an EV1000TM Clinical Platform for fluid/circulatory management. The establishment of high-visibility monitors was useful for evaluating the condition and confirming the effects. As there are marked changes in hemodynamics, the CV pressure, which has been used as a parameter of fluid management, is not reliable in renal failure patients with a high incidence of cardiovascular complications. Advances in noninvasive circulatory monitoring with dynamic indices may improve the safety of anesthetic management during renal transplantation.
The journal of medical investigation : JMI
LID201403172003.pdf 270 KB